Low incidence of metastasis and recurrence from cutaneous squamous cell carcinoma found in a UK population: Do we need to adjust our thinking on this rare but potentially fatal event?

Abstract

Background and Methods Cutaneous squamous cell carcinoma (cSCC) is the commonest skin cancer with metastatic potential, however, reported rates of metastasis varies greatly. All cases of primary cSCC on the Isle of Wight between 2005 and 2014 were identified and retrospectively followed for recurrence and/or metastasis. Primary outcome was to identify the rate of metastasis/recurrence from cSCC. Secondary outcomes included associated risk factors for metastasis/recurrence, death from cSCC, and time from diagnosis of primary cSCC to event. Results A total of 1122 patients with 1495 tumors were identified within the study period. A total of 18 metastasized and 40 recurred, an overall incidence of 1.2% and 2.7%, respectively. Eight patients died from their disease. Conclusions Risk of metastasis from cSCC in the UK general population is likely to be in the order of 1.2%. Where metastasis occurs this is often within 2 years. Recurrence rates are higher following curette and cautery. Discussion If treated adequately both recurrence and metastasis from cSCC is a rare event. Not all cSCC cases need follow‐up instead time should be spent educating patients around signs of recurrence/metastasis then discharged, relieving burden on secondary care. Multi‐disciplinary teaming meetings are expensive and should be limited to complex cases.

Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta‐analysis

“…Studies included for analyses were published between 1957 and 2017; the number of included patients ranged from 40 to 6164 (Table 1). [22][23][24][25]30,44,47,[77][78][79][80][81][82][83][84][85][86][87][88][89] These studies were performed in the USA, New Zealand, Australia, The Netherlands, Denmark, the UK, Greece, Turkey and Israel. Median follow-up time ranged from 24 to 81 months.…”

“…Fourteen studies included patients with cSCC on the total body, [22][23][24]30,44,47,[78][79][80][81]83,84,87,88 six studies with patients with cSCC in the head and neck area. 25,77,82,85,86,89 One study also included specified data on 10 OTR, that were excluded for this study as it were less than 25 patients.…”

“…25,77,82,85,86,89 One study also included specified data on 10 OTR, that were excluded for this study as it were less than 25 patients. 88 Two studies comparing immunocompetent population and OTR Both studies were performed in the USA and studied total body cSCC. 44,47 One study retrospectively compared 153 OTR with cSCC with 154 numerically matched cSCC patients in immunocompetent patient that were randomly chosen from a pool of patients.…”

“…30 One study reported separately on 10 OTR patients in their cohort. 88 Two studies compared OTR to the immunocompetent population. 44,47 In 14 studies, the outcome of metastasis was specifically noted in the study aim.…”

“…44,47 In 14 studies, the outcome of metastasis was specifically noted in the study aim. 22,25,44,48,50,[78][79][80][81][82]84,[87][88][89] Metastasis risk: pooled analysis Summary estimates were calculated for the proportion of patients with metastasis in the studies reporting on total body (Fig. 2) and cSCC of the head and neck area (Fig.…”